Abstract: The need to protect and preserve urban environments can never be emphasised enough given the essential role cities in general and housing in particular play in the people’s lives be it physically, economically or socially. Although numerous studies have been conducted on informal settlements, particularly their causes, prevalence and general conditions, very little is understood about the impact of water, sanitation and solid waste conditions on residents. Interestingly, the struggles people face on a daily basis as they make efforts to access water, sanitation and waste management services are not well documented. This work therefore explored in detail the nature of relationships that are forged by service providers, the level of service provision and daily experiences of the residents of Alexandra. A case study research design and a qualitative research approach were adopted and applied to gather relevant and meaningful data using interviews of key stakeholders and the residents. The work extended the frontiers of existing knowledge by bringing to the fore new insights on the direct impact of poor state of water supply, deplorable sanitation and glaring inadequacies in municipal solid waste management on residents. First, temporary water storage facilities such as drums and buckets; a mechanism to respond to water supply challenges; results in small particles being formed at the bottom of the facility and if consumed they result in water-borne diseases. Second, the use of pit latrines and the bucket system as a response to poor sanitation in Alexandra has given rise to outbreaks of diseases that are related and caused directly by lack of proper sanitation. Third, the absence of waste disposal facilities and the erratic nature of waste collection services have forced residents to use open pits in their yards to dispose waste or have resorted to open fire burning of waste thus exposing residents...